Why vaccinate children against COVID?

Pharmaceutical giant Pfizer is now testing a third vaccine dose in children under five, claiming two doses are not strong enough:

Pfizer announced the change after preliminary analysis found the immune response to the very low-dose shots, the company is testing in the children, was not as strong as expected.

The news is disappointing for families anxious to vaccinate their kids…

If the three-dose trial is successful, Pfizer and its partner BioNTech said they plan to apply to regulators for an emergency use authorization sometime during the first half of 2022…

Prime Minister Scott Morrison said last week Australia’s COVID-19 vaccination program will be extended to all children aged five to 11 years from 10 January 2022, after the government accepted recommendations from the Australian Technical Advisory Group on Immunisation (ATAGI).

ATAGI vaccination experts have recommended the Pfizer vaccine be made available to all children aged five to 11-years-old to help prevent serious illness from COVID-19.

Why is Australia seeking to vaccinate children for COVID when COVID presents minimal risk to children? Vaccination also does not stop the virus from spreading – just look at NSW where 93% of people aged 12-plus are double-vaccinated, or anywhere else in the world.

As noted by Dr Cameron Murray:

The risk of serious illness or death with COVID is far more age-skewed than most viruses. In the below figure I show this skew. COVID is a serious disease for the elderly.

 

I also plot vaccine risks in the dashed orange. You might not be able to see it because it is so close to the axis. For age 70, the benefit-to-cost ratio of the vaccine is about 250x (i.e. the blue line is 250 times higher than the dashed orange line). A great outcome and something anyone would be foolish not to recommend.

But exponential curves are deceiving. Let’s zoom in on this curve for young age cohorts. I do this below (curve equation is 10^(-3.27 + 0.0524xage)). Notice now that we are way down near the vaccine risk. It’s close. I show a broad range of risks and call this COVID curve the risk of serious illness. I do this because reality doesn’t follow the neat equation I used to plot the curve and children are likely even lower risk than shown.

In short, because the age skew of COVID risk is so severe, these huge many-hundred-times benefit-to-cost ratios can reverse at low ages so that the costs are many times the benefits. This is why so many doctors are calling for a halt to mandates for vaccinating children.

We should let this well-known information about COVID guide us rather than politics and panic.

The World Health Organization’s (WHO) Interim statement on COVID-19 vaccination for children and adolescents also notes that COVID poses minimal health risks to children:

Overall, there are proportionally fewer symptomatic infections, and cases with severe disease and deaths from COVID-19 in children and adolescents, compared with older age groups. Age-disaggregated cases reported to WHO from 30 December 2019 to 25 October 2021(3) show that children under five years of age represent 2% (1 890 756) of reported global cases and 0.1% (1 797) of reported global deaths. Older children and younger adolescents (5 to 14 years) account for 7% (7 058 748) of reported global cases and 0.1% (1 328) of reported global deaths while older adolescents and young adults (15 to 24 years) represent 15% (14 819 320) of reported global cases and 0.4% (7 023) of reported global deaths. Deaths for all ages less than 25 years represented less than 0.5% of reported global deaths.

Children and adolescents usually demonstrate fewer and milder symptoms of SARS-CoV-2 infection compared to adults and are less likely than adults to experience severe COVID-19(4). Milder symptoms and asymptomatic presentations may mean less frequent care seeking in these groups, thus children and adolescents tend to be tested less and cases may go unreported…

The preexisting conditions associated with higher risk of severe COVID-19 include type 2 diabetes, asthma, heart and pulmonary diseases, and neurologic, neurodevelopmental (in particular, Down Syndrome) and neuromuscular conditions(11)…

One systematic review suggests that there may be larger impact of paediatric COVID-19 related fatality in low to middle income countries versus high income countries (12).

I personally know one adult that has been hospitalised by Pfizer with pericarditis. The risks may be low, but they aren’t trivial.

We should always be concerned when a drug company like Pfizer approaches the federal government seeking “an emergency use authorization” to sell vaccines to kids. Always follow the money.

Disclosure: Me, my wife and our teenage son are fully vaccinated. Our younger daughter is not.

Unconventional Economist
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